title: Thirty years of portraying oral health through models: what have we accomplished in oral health-related quality of life research?
abstract: OBJECTIVE
  This paper critically examines the different models of oral health aimed at representing oral health-related quality of life (OHRQoL) and explores the extent to which such models changed conceptually to accommodate current theories and empirical knowledge of oral function, impairment and disability.
  
  
  METHODS
  A critical synthesis of the existing literature based on a comprehensive yet non-systematic review using Ovid-MEDLINE was performed. Full text of manuscripts available on models of oral health and OHRQoL published in English between 1 January 1950 and 30 June 2013 were identified.
  
  
  RESULTS
  Nineteen manuscripts were identified presenting and discussing various models of oral health and OHRQoL that are predominantly negative and linear. These models are mostly based on sick role-related theories and do not readily accommodate the biopsychosocial theories of oral health. Alternative portrayals have emerged to include positive behaviours and adaptive strategies dynamically, but have yet to influence patient care and the development of subjective OHRQoL indicators.
  
  
  CONCLUSIONS
  Despite the multitude of graphical representations of concepts, dental research has remained somewhat 'linear' in portraying the consequences of oral diseases as a one-way street. Although the conceptualization of oral health has evolved in the past 30 years, dental research still refers to it as the absence of disease in more than half a dozen models of OHRQoL focused mostly on dysfunction and disability.
authors.affiliation: Oral Health Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, Canada, brondani@dentistry.ubc.ca.
authors.forename: Mario A
authors.initials: MA
authors.lastname: Brondani
authors.forename: Michael I
authors.initials: MI
authors.lastname: MacEntee
mesh_terms: D003753:Dental Health Surveys / Q000639:trends*; D018865:Dental Research / Q000639:trends*; D006302:Health Services Research; D006304:Health Status; D006801:Humans; D008960:Models, Psychological; D009909:Oral Health; D017063:Outcome Assessment, Health Care / Q000379:methods; D011594:Psychometrics; D011788:Quality of Life / Q000523:psychology*; D011795:Surveys and Questionnaires; D013997:Time Factors